May 16 2012

george

Dabigatran and the iSTAT

From “SwimRose:” Hi George, We recently had a case in our ER of a stroke patient on Pradaxa giving an INR of 2.0 with ISTAT, but the main lab instrument, an IL ACL, gave 1.1. Please comment. Hello, and thank you for your question, which drove me to an early-morning search of theAbbott Diagnostics site for […]

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Anticoagulant Therapy

May 11 2012

george

Ecarin Clotting Time: Dr. Zuckerman

On April 29, Crystal Azavedo asked about laboratories that monitor dabigatran with the ecarin clotting time (ECT). Last week at the Thrombosis and Hemostasis Summit of North America I became reacquainted with long-time colleague, Dr. Leon Zuckerman, founder of Coagulation Consultants of Des Plaines, Illinois. Coagulation Consultants is a full-service hemostasis reference laboratory that also offers the ECT. It was good to see Dr. […]

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Anticoagulant Therapy

May 7 2012

george

Reprise: Validating POC INRs

Back to our April 24 anticoagulation clinic manager’s question about when to validate a prolonged point of care (POC) prothrombin time with international normalized ratio (PT/INR). George spoke with representatives of Roche Diagnostics, distributor of Coag-U-Chek instruments, while attending the May 3–5 Thrombosis and Hemostasis Summit of North America meeting in Chicago. While Roche contends this is a local decision and […]

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Anticoagulant Therapy

May 6 2012

george

Reprise: Validating POC INRs

Back to our April 24 anticoagulation clinic manager’s question about when to validate a prolonged point of care (POC) prothrombin time with international normalized ratio (PT/INR). George spoke with representatives of Roche Diagnostics, distributor ofCoag-U-Chek instruments, while attending the May 3–5 Thrombosis and Hemostasis Summit of North America meeting in Chicago. While Roche contends this is a local decision and […]

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Anticoagulant Therapy

Apr 29 2012

george

Poll: How Many Monitor “Dabi” With ECT?

Good afternoon George! Are there any labs out there using the ecarin clotting time to test for dabigatran level? We know it doesn’t “need” to be monitored, but we also realize that there will be practitioners looking for such information. I have trialed the ECA-T kit from Diagnostica Stago with Aniara calibrators/controls. Thanks! Crystal Azevedo. Hi, […]

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Anticoagulant Therapy

Apr 27 2012

george

Hemolysis and Heparin Anti-Xa

A message from “Danagah:” Hi, George, How would you handle a sample for a chromogenic heparin anti-Xa assay if a patient is experiencing in vivo hemolysis and you cannot obtain a sample that is not hemolyzed? Would it make a difference as to the degree of hemolysis as to even accepting the sample? We reject […]

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Anticoagulant Therapy

Apr 17 2012

george

ASCLS-Missouri Meeting April 17-19

The Missouri branch of the American Society for Clinical Laboratory Science holds its annual state meeting at the Millennium Hotel in St. Louis, April 17-19, 2012. George provides a presentation on Thursday, April 19, “Monitoring the New Anticoagulants, Whatever Happened to the PT and PTT?” from 1 to 2:30. Attached below is the PowerPoint handout. […]

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Anticoagulant Therapy

Apr 10 2012

george

Dabigatran Clearance

Another post from Bob Gosselin (we hit the mother lode today!): GF: Re dabigatran clearing in 24 hours: This is not necessarily so, depending on the patient, as we have seen “dabi” levels (q12 drug) with trough before next dose of ~150ng/mL. So I would highly suggest using thrombin times for assessing the clearing of drug, as […]

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Anticoagulant Therapy

Apr 10 2012

george

POC INRs

From Bob Gosselin: Hey GF, re point of care (POC) international normalized ratios (INRs), assuming that you are collecting a citrated sample for testing, a high hematocrit (HCT) should not matter for a system that employs fingerstick whole blood, since there is no citrate:plasma ratio issue at hand with using whole blood. Viscosity may be an issue […]

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Anticoagulant Therapy

Apr 3 2012

george

ACC

Here is a summary of the just-ended American College of Cardiology meeting in Chicago. It appears there was a lot of attention given to the new oral anticoagulants, especially to dabigatran (Pradaxa), which has been available since 2010 in the US. I’ve been seeing lawyer’s ads on TV recently, 1-800-BAD-DRUG, focusing on Pradaxa. Does Pradaxa deserve this […]

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Anticoagulant Therapy